Individual provider Active NPI

Maryana Peravozchykava, AU.D.

  • Audiologist
  • Brooklyn, NY
National Provider Identifier
1043613029
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
00002555 Issued in NY
Practice address
2560 Ocean Ave Ste 2a
Brooklyn, NY 11229-4507
Phone
(718) 646-1234
Fax
(718) 646-1235
NPI assigned
Oct 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 00002555 NY Primary

Addresses

Primary practice location

2560 Ocean Ave Ste 2a
Brooklyn, NY 11229-4507

Mailing address

2560 Ocean Ave Ste 2a
Brooklyn, NY 11229-4507
Phone (718) 646-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150123000109 NY Practitioner - Qualified Audiologist 6103140132 Reassigns benefits to 2 organizations
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Facial Plastic Surgery Otolaryngology LLCGroup PAC ID 6305855784, 3 clinicians
Gennady Ukrainsky, MD PCGroup PAC ID 9436215092, 2 clinicians

Practice addresses (Care Compare)

2560 Ocean Ave
FL 2
Brooklyn, NY 11229-4507
Phone (718) 646-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002555NYMDArt Therapist
00002555NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Facial Plastic Surgery Otolaryngology LLC CurrentSince Oct 1, 2016 Accepting new patients
Gennady Ukrainsky MD PC CurrentSince Oct 1, 2016 Accepting new patients

Locations

2560 Ocean Ave
#2A
Brooklyn, NY 11229
Phone (347) 398-1693

2560 Ocean Ave
#2
Brooklyn, NY 11229
Phone (212) 979-4771

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BCGEAD/Endpoint/BCGEAD
  • FHIR API: https://fhir4.healow.com/fhir/r4/AEGEAD/Endpoint/AEGEAD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1043613029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 OCEAN AVE STE 2A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294507",
            "telephone_number": "718-646-1234",
            "fax_number": "718-646-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 OCEAN AVE STE 2A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294507",
            "telephone_number": "718-646-1234",
            "fax_number": "718-646-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERAVOZCHYKAVA",
        "first_name": "MARYANA",
        "name_prefix": "Ms.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-03",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "00002555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.